Background: Although the MPOG database contains rich electronic health record (EHR) and administrative data for millions of patients, many important perioperative research questions require additional data not collected consistently and routinely across all MPOG centers. The MPOG coordinating center will organize an annual “enhanced” observational study across the member centers that integrates existing MPOG automated data collection infrastructure with focused, prospective observational data collection. The result will be a unique perioperative pragmatic observational dataset that takes advantage of the best of various data collection methodologies. Each year, all MPOG centers participating in the enhanced observational study program will dedicate a 2-4 week period to shift existing research personnel to collect additional data elements that cannot be reliably extracted from the EHR or administrative systems. Using an MPOG research data collection application, research personnel at each center would manually collect prospectively defined structured data elements for all eligible patients. The MPOG coordinating center software development, data extraction, statistical analysis, research investigator, and collaboration services will be offered free of charge to the selected proposal’s principal investigators. Each participating center’s data collection efforts would also be granted to the winning proposal. Building upon the lessons learned from the Royal College of Anaesthetists’ NAP and European Society of Anaesthesiology’s CTN infrastructure, we request submission of proposals by active MPOG centers.